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Kogan LR, Rishniw M. Career transition plans of veterinarians in clinical practice. Front Vet Sci 2024; 11:1433891. [PMID: 39132443 PMCID: PMC11310143 DOI: 10.3389/fvets.2024.1433891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 07/15/2024] [Indexed: 08/13/2024] Open
Abstract
Objective Gain an understanding of the career transition plans of veterinarians in clinical practice. Sample Veterinary members of the Veterinary Information Network (VIN) working as small animal clinicians. Procedures An electronic survey distributed via the VIN data collection portal. Results A total of 1,256 responses from veterinarians in clinical practice were analyzed, with 61% indicating they plan to decrease their clinical work, and 31% to stop entirely within the next 5 years. The most common reasons for these choices were to have more free time for oneself and/or family/friends (76%), to maintain good health (59%), and feeling burned out (50%). Factors that might entice them to retain their current number of clinical hours included reduced workload or shorter hours (42%), financial incentivization (38%), and improved working conditions (26%). Concerns related to retirement were common with 47% of participants in our study reported feeling concerned about the loss of professional identity, 34% reported concern about reduced social connections, and 28% reported concern as to how they would fill their time. Conclusions and clinical relevance The reported desire to reduce/stop one's clinical work within the next 5 years by 42% of veterinarians ≤44 years of age, with burnout a primary predictor, offers insights into the necessity of change at the organizational, systemic (versus individual) level. The fact that many participants reported concerns related to retirement and 32% reported that they did not have adequate retirement information suggests a need for supportive services to help ensure a successful transition.
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Affiliation(s)
- Lori R. Kogan
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Mark Rishniw
- Veterinary Information Network, Davis, CA, United States
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Gettens Bourgea KM, Erkkinen M, Gale SA, McGinnis SM, Daffner KR, Silbersweig D, Schildkrout B. Case Studies 7A and 7B: Two Physician-Patients With Early Alzheimer's Disease and Differing Levels of Insight. J Neuropsychiatry Clin Neurosci 2024; 36:220-227. [PMID: 38835225 DOI: 10.1176/appi.neuropsych.20230217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Affiliation(s)
- Katelyn M Gettens Bourgea
- Departments of Neurology (Gettens Bourgea, Erkkinen, Gale, McGinnis, Daffner) and Psychiatry (Silbersweig, Schildkrout), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Michael Erkkinen
- Departments of Neurology (Gettens Bourgea, Erkkinen, Gale, McGinnis, Daffner) and Psychiatry (Silbersweig, Schildkrout), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Seth A Gale
- Departments of Neurology (Gettens Bourgea, Erkkinen, Gale, McGinnis, Daffner) and Psychiatry (Silbersweig, Schildkrout), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Scott M McGinnis
- Departments of Neurology (Gettens Bourgea, Erkkinen, Gale, McGinnis, Daffner) and Psychiatry (Silbersweig, Schildkrout), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Kirk R Daffner
- Departments of Neurology (Gettens Bourgea, Erkkinen, Gale, McGinnis, Daffner) and Psychiatry (Silbersweig, Schildkrout), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - David Silbersweig
- Departments of Neurology (Gettens Bourgea, Erkkinen, Gale, McGinnis, Daffner) and Psychiatry (Silbersweig, Schildkrout), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Barbara Schildkrout
- Departments of Neurology (Gettens Bourgea, Erkkinen, Gale, McGinnis, Daffner) and Psychiatry (Silbersweig, Schildkrout), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston
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Couser GP, Hagen PT, Cowl CT, Newcomb RD, Swift MD. Part Two: Managing Physicians as Patients and Their Safe Return to Work. Mayo Clin Proc 2024; 99:997-1005. [PMID: 38839190 DOI: 10.1016/j.mayocp.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/14/2023] [Accepted: 10/27/2023] [Indexed: 06/07/2024]
Abstract
This second installment in a 3-part series about physicians as patients explores challenges in communication and role definition while managing their care and safe return to work. In the first article of the series, authors reviewed unique characteristics that make physicians different as patients, with some general guidance about how to approach their care. Although most treating physicians receive little occupational training, health issues commonly have an impact on work with imperative to address work issues promptly for best outcome. This paper demystifies the challenge of managing work status and discusses navigating common physical and cognitive issues while maintaining role clarity. The treating clinician reading this paper will learn to avoid common pitfalls and be better equipped to provide initial assessments and interventions to keep physicians working safely, keeping in mind licensure issues and reporting requirements. Part Three of the series will focus on the most common mental health issues seen in physicians.
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Affiliation(s)
- Greg P Couser
- Mayo Clinic Physician Health Center, Public Health, Infectious Disease, and Occupational Medicine, Mayo Clinic, Rochester, MN.
| | - Philip T Hagen
- Mayo Clinic Physician Health Center, Public Health, Infectious Disease, and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Clayton T Cowl
- Mayo Clinic Physician Health Center, Public Health, Infectious Disease, and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Richard D Newcomb
- Mayo Clinic Physician Health Center, Public Health, Infectious Disease, and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Melanie D Swift
- Mayo Clinic Physician Health Center, Public Health, Infectious Disease, and Occupational Medicine, Mayo Clinic, Rochester, MN
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Ruelle Y, Haghighi S, Guillot O. Effects of a short training workshop on the insertion/removal of intrauterine devices and contraceptive implants by general practice residents and their supervisors in France. Contraception 2023; 127:110117. [PMID: 37467922 DOI: 10.1016/j.contraception.2023.110117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The skill of general practitioners (GPs) in performing the insertion/removal of intrauterine devices (IUDs) and contraceptive implants is one of the factors that determines patient's access to these contraceptive devices. In France, GP residents have few opportunities to perform these procedures during their internships. This study aimed to measure the effects of a single short training workshop on the number of residents and supervisors offering these procedures. STUDY DESIGN Each participant attended a unique 2-hour session. After a brief didactic review and video presentations, participants received hands-on training in technical procedures (insertion/removal of IUDs and contraceptive implants) using procedural simulators. The evaluation measured the number of GPs offering these procedures before, 1 month after, and 3 months after the workshops. RESULTS Fourteen sessions were organized from February 2017 to June 2022. Among the 387 residents and 123 supervisors invited, 143 (37.0%) and 56 (45.5%), respectively, participated in this workshop. Of 199 participants, 66.3% completed all questionnaires. There was a significant increase in the number of GPs inserting IUDs by direct method 3 months after training (20.5% vs 9.0%, p = 0.005). GPs providing information to patients about contraceptive implants were significantly higher at 1 month (80.6% vs 64.8%, p = 0.001) but this increase was no longer significant at 3 months (75.0%, p = 0.07). Residents changed their practices more than their supervisors, and women more than men. CONCLUSIONS A short training workshop increased the number of GPs inserting IUDs, influenced by the gender and the number of years practicing. IMPLICATIONS A single workshop had positive effects on IUD insertion and patient education about contraceptive implants. Repeating several times this training could be an option in the initial and ongoing training of general practitioners. Work on the general practitioners' own feeling of legitimacy in their practice context could also increase the effectiveness of these workshops and the practical implementation of the procedures taught.
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Affiliation(s)
- Yannick Ruelle
- Université Sorbonne Paris Nord, Département Universitaire de Médecine Générale, DUMG, Villetaneuse, France; Université Sorbonne Paris Nord, Laboratoire Educations et Promotion de la Santé, LEPS, UR 3412, Villetaneuse, France; Centres Municipaux de Santé Universitaires, Pantin, France.
| | - Sophie Haghighi
- Université Sorbonne Paris Nord, Département Universitaire de Médecine Générale, DUMG, Villetaneuse, France; Centres Municipaux de Santé Universitaires, Pantin, France
| | - Ophélie Guillot
- Université Sorbonne Paris Nord, Département Universitaire de Médecine Générale, DUMG, Villetaneuse, France; Centre Municipal de Santé, Livry-Gargan, France
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Lamoureux C, Hanna TN, Callaway E, Bruno MA, Weber S, Sprecher D, Johnson TD. Radiologist age and diagnostic errors. Emerg Radiol 2023; 30:577-587. [PMID: 37458917 DOI: 10.1007/s10140-023-02158-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/10/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Previous investigations into the causes of error by radiologists have addressed work schedule, volume, shift length, and sub-specialization. Studies regarding possible associations between radiologist errors and radiologist age and timing of residency training are lacking in the literature, to our knowledge. The aim of our study was to determine if radiologist age and residency graduation date is associated with diagnostic errors. METHODS Our retrospective analysis included 1.9 million preliminary interpretations (out of a total of 5.2 million preliminary and final interpretations) of imaging examinations by 361 radiologists in a US-based national teleradiology practice between 1/1/2019 and 1/1/2020. Quality assurance data regarding the number of radiologist errors was generated through client facility feedback to the teleradiology practice. With input from both the client radiologist and the teleradiologist, the final determination of the presence, absence, and severity of a teleradiologist error was determined by the quality assurance committee of radiologists within the teleradiology company using standardized criteria. Excluded were 3.2 million final examination interpretations and 93,963 (1.8%) of total examinations from facilities reporting less than one discrepancy in examination interpretation in 2019. Logistic regression with covariates radiologist age and residency graduation date was performed for calculation of relative risk of overall error rates and by major imaging modality. Major errors were separated from minor errors as those with a greater likelihood of affecting patient care. Logistic regression with covariates radiologist age, residency graduation date, and log total examinations interpreted was used to calculate odds of making a major error to that of making a minor error. RESULTS Mean age of the 361 radiologists was 51.1 years, with a mean residency graduation date of 2001. Mean error rate for all examinations was 0.5%. Radiologist age at any residency graduation date was positively associated with major errors (p < 0.05), with a relative risk 1.021 for each 1-year increase in age and relative risk 1.235 for each decade as well as for minor errors (p < 0.05, relative risk 1.007 for each year, relative risk 1.082 for each decade). By major imaging modality, radiologist age at any residency graduation date was positively associated with computed tomography (CT) and X-ray (XR) major and minor error, magnetic resonance imaging (MRI) major error, and ultrasound (US) minor error (p < 0.05). Radiologist age was positively associated with odds of making a major vs. minor error (p < 0.05). CONCLUSIONS The mean error rate for all radiologists was low. We observed that increasing age at any residency graduation date was associated with increasing relative risk of major and minor errors as well as increasing odds of a major vs. minor error among providers. Further study is needed to corroborate these results, determine clinical relevance, and highlight strategies to address these findings.
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Affiliation(s)
| | - Tarek N Hanna
- Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 550 Peachtree Rd, Atlanta, GA, 30308, USA
| | - Edward Callaway
- Virtual Radiologic, 11995 Singletree Ln #500, Eden Prairie, MN, 55344, USA
| | - Michael A Bruno
- Penn State Milton S. Hershey Medical Center, 500 University Dr, Hershey, PA, 17033, USA
| | - Scott Weber
- Virtual Radiologic, 11995 Singletree Ln #500, Eden Prairie, MN, 55344, USA
| | - Devin Sprecher
- Virtual Radiologic, 11995 Singletree Ln #500, Eden Prairie, MN, 55344, USA
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Schriger DL, Schenkel S. Fine Wine or Stale Bread: The Aging Emergency Physician. Ann Emerg Med 2023; 82:313-315. [PMID: 37178099 DOI: 10.1016/j.annemergmed.2023.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 05/15/2023]
Affiliation(s)
- David L Schriger
- Department of Emergency Medicine, University of California Los Angeles, Los Angeles, CA.
| | - Stephen Schenkel
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
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Can You Be Too Old To Practice Medicine? STRUCTURAL HEART 2023. [DOI: 10.1016/j.shj.2023.100165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Whalley LJ. Cognitive Screening in Aging Physicians: Faith in Numbers. Neurol Clin Pract 2020; 11:89-90. [PMID: 33842058 DOI: 10.1212/cpj.0000000000000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Lawrence J Whalley
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
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